Content Analysis of E-cigarette News Articles Amidst the 2019 Vaping-Associated Lung Injury (EVALI) Outbreak in the United States

Jeong, Michelle; Singh, Binu; Wackowski, Olivia A; Mukherjee, Rohit; Steinberg, Michael B.; Delnevo, Cristine D.

doi:10.1093/ntr/ntab203

Cited by 12 publications

(18 citation statements)

References 15 publications

(27 reference statements)

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“…These findings may have been shaped by early CDC/official communications that warned about use of any e-cigarette/vaping products, as well as public exposure to media coverage simultaneously discussing other e-cigarette issues—including growing e-cigarette use among youth, attributed to flavoured products and JUUL 6 7 9. Additionally, lawmakers passed numerous local and state bans on flavoured e-cigarettes in the wake of EVALI,18 likely reinforcing conflation of these issues for the public.…”

Section: Discussionmentioning

confidence: 99%

“…The extent to which the public followed and understood the EVALI investigation is unclear. Although the EVALI outbreak received substantial news coverage during its peak,5 6 coverage declined with the subsequent fall in cases and the onset of COVID-19. The CDC posted its last EVALI web page update on 25 February 2020,1 shortly before COVID-related shutdowns across the USA in March 2020.…”

Section: Introductionmentioning

confidence: 99%

“…The CDC posted its last EVALI web page update on 25 February 2020,1 shortly before COVID-related shutdowns across the USA in March 2020. Furthermore, early news discussion of EVALI often simultaneously discussed the high prevalence of youth vaping and JUUL popularity, potentially conflating these issues and products 6 7. A US poll assessing EVALI awareness in January 2020, 4 months after its peak, found more respondents linked EVALI with using e-cigarettes like JUUL (66%) than with vaping THC (28%) 8…”

Section: Introductionmentioning

confidence: 99%

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Over 1 year later: smokers’ EVALI awareness, knowledge and perceived impact on e-cigarette interest

et al. 2022

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ObjectivesThe e-cigarette or vaping product use-associated lung injury (EVALI) outbreak caused serious lung injuries in over 2800 people in the USA in 2019. By February 2020, most cases were determined as linked with vaping tetrahydrocannabinol (THC), including black market products using vitamin E acetate. This study examined smokers’ EVALI awareness, knowledge and perceived impact on their e-cigarette interest approximately 16 months after its peak.DesignBetween January and February 2021, we surveyed 1018 adult current smokers from a nationally representative US research panel. Participants were asked if they had heard about EVALI prior to COVID-19, knew its main cause, and if EVALI had impacted their interest in future e-cigarette use.ResultsApproximately 54% of smokers had heard of EVALI. Among those who had heard of EVALI (n=542), 37.3% believed its main cause was e-cigarettes used to vape nicotine, like JUUL. Fewer (16.6%) thought the main cause was products for vaping marijuana/THC, and 20.2% did not know. About 29% had heard vitamin E acetate was associated with EVALI, and 50.9% indicated EVALI made them less interested in using e-cigarettes in the future. EVALI awareness was significantly associated with e-cigarette risk perceptions (ie, that e-cigarettes are as harmful as smoking).ConclusionsDespite the passage of time, considerable lack of knowledge and misperceptions about EVALI remain among those who smoke. Our findings suggest the need for continued efforts to promote better understanding of EVALI and appropriate behavioural and policy responses.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Over 1 year later: smokers’ EVALI awareness, knowledge and perceived impact on e-cigarette interest

et al. 2022

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“…The outbreak was widely reported in the media. 8–11 In the United States, 62% of all news articles about e-cigarettes published in 2019 mentioned ‘EVALI’, 9 and news reporting peaked in September 2019. 8–10 The articles that mentioned the outbreak were often accompanied by warnings of the health harms of vaping, concerns about youth vaping, and were less likely to mention that vaping is less risky than smoking.…”

Section: Introductionmentioning

confidence: 99%

“… 8–10 The articles that mentioned the outbreak were often accompanied by warnings of the health harms of vaping, concerns about youth vaping, and were less likely to mention that vaping is less risky than smoking. 9 , 10 There was also a greater emphasis on avoiding the use of all vaping products than avoiding vaping THC specifically, 10 and on deaths related to vaping rather than vaping contaminated THC. 9 Outside of the US, preliminary data indicate that the prevalence of news articles about e-cigarettes also peaked in September 2019 in Canada and the United Kingdom.…”

Section: Introductionmentioning

confidence: 99%

Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)

East

Reid

Burkhalter

et al. 2022

Nicotine &Amp; Tobacco Research

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Introduction Little is known about the international impact of ‘EVALI’ on youth perceptions of vaping harms. Methods Repeat cross-sectional online surveys of youth aged 16-19 in England, Canada, and the US before (2017, 2018), during (2019Aug/Sept), and after (2020Feb/Mar, 2020Aug) the ‘EVALI’ outbreak (N=63,380). Logistic regressions assessed trends, country differences, and associations between exposure to negative news stories about vaping and vaping harm perceptions. Results Exposure to negative news stories increased between 2017 and Feb/Mar 2020 in England (12.6% to 34.2%), Canada (16.7% to 56.9%), and the US (18.0% to 64.6%), accelerating during (2019) and immediately after (Feb/Mar 2020) the outbreak (p<.001) before returning to 2019 levels by Aug 2020. Similarly, accurate perception that vaping is less harmful than smoking declined between 2017 and Feb/Mar 2020 in England (77.3% to 62.2%), Canada (66.3% to 43.3%), and the US (61.3% to 34.0%), again accelerating during and immediately after the outbreak (p<.001). Perception that vaping takes less than a year to harm users’ health and worry that vaping will damage health also doubled over this period (p≤.001). Time trends were most pronounced in the US. Exposure to negative news stories predicted perception that vaping takes less than a year to harm health (AOR=1.55, 1.48-1.61) and worry that vaping will damage health (AOR=1.32, 1.18-1.48). Conclusions Between 2017 and February/March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. Effects were seen in all countries but were most pronounced in the US. IMPLICATIONS This is the first study to examine changes in exposure to news stories about vaping, and perceptions of vaping harms, among youth in England, Canada, and the US before, during, and after ‘EVALI’. Between 2017 and February/March 2020, youth exposure to negative news stories, and perceptions of vaping harms, increased, and increases were exacerbated during and immediately after ‘EVALI’. By August 2020, exposure to negative news stories returned to 2019 levels, while perceptions of harm were sustained. Exposure to negative news stories also predicted two of three harm perceptions measures. Overall, findings suggest ‘EVALI’ may have exacerbated youth’s perceptions of vaping harms internationally.

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Trends in Harm Perceptions of E-Cigarettes vs Cigarettes Among Adults Who Smoke in England, 2014-2023

Jackson,

Tattan-Birch,

East

et al. 2024

JAMA Netw Open

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ImportanceElectronic cigarettes (e-cigarettes) are less harmful to users than combustible cigarettes. However, public health and media reporting have often overstated the potential risks of e-cigarettes, and inaccurate perceptions of the harms of vaping relative to smoking are pervasive.ObjectiveTo examine time trends in harm perceptions of e-cigarettes compared with combustible cigarettes among adults who smoke.Design, Setting, and ParticipantsThis nationally representative monthly cross-sectional survey study was conducted from November 2014 to June 2023 in England. Participants were adults who currently smoke.Main Outcomes and MeasuresParticipants were asked whether they thought e-cigarettes were less harmful, equally harmful, or more harmful than cigarettes, or did not know, with the proportion responding less harmful (vs all other responses) as the primary outcome. Logistic regression was used to test associations between survey wave and participants’ perceptions of the harms of e-cigarettes.ResultsData were collected from 28 393 adults who smoke (mean [SD] age, 43.5 [17.3] years; 13 253 [46.7%] women). In November 2014, 44.4% (95% CI, 42.0%-46.8%) thought e-cigarettes were less harmful than cigarettes, 30.3% (95% CI, 28.2%-32.6%) thought e-cigarettes were equally harmful, 10.8% (95% CI, 9.4%-12.3%) thought they were more harmful, and 14.5% (95% CI, 12.9%-16.4%) did not know. However, by June 2023, the proportion who thought e-cigarettes were less harmful had decreased by 40% (prevalence ratio, 0.60; 95% CI, 0.55-0.66), and the proportion who thought e-cigarettes were more harmful had more than doubled (prevalence ratio, 2.16; 95% CI, 1.84-2.54). Changes over time were nonlinear: late 2019 saw a sharp decline in the proportion who thought e-cigarettes were less harmful and increases in the proportions who thought they were equally or more harmful. These changes were short-lived, returning to pre-2019 levels by the end of 2020. However, perceptions worsened again from 2021 up to the end of the study period: the proportion who thought e-cigarettes were more harmful increased to a new high, and the proportion who thought e-cigarettes were less harmful decreased to levels comparable to those in late 2019. As a result, in June 2023, the perception that e-cigarettes were equally as harmful as cigarettes was the most commonly held view among adults who smoke (33.7%; 95% CI, 31.4%-36.1%), with roughly similar proportions perceiving e-cigarettes to be less (26.7%; 95% CI, 24.6%-28.9%) and more (23.3%; 95% CI, 21.1%-25.7%) harmful.Conclusions and RelevanceThis survey study of adults who smoke in England found that harm perceptions of e-cigarettes have worsened substantially over the last decade, such that most adults who smoked in 2023 believed e-cigarettes to be at least as harmful as cigarettes. The timing of the 2 most notable changes in harm perceptions coincided with the e-cigarette, or vaping product, use-associated lung injury outbreak in 2019 and the recent increase in youth vaping in England since 2021.

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Content Analysis of E-cigarette News Articles Amidst the 2019 Vaping-Associated Lung Injury (EVALI) Outbreak in the United States

Cited by 12 publications

References 15 publications

Over 1 year later: smokers’ EVALI awareness, knowledge and perceived impact on e-cigarette interest

Over 1 year later: smokers’ EVALI awareness, knowledge and perceived impact on e-cigarette interest

Exposure to Negative News Stories About Vaping, and Harm Perceptions of Vaping, Among Youth in England, Canada, and the United States Before and After the Outbreak of E-cigarette or Vaping-Associated Lung Injury (‘EVALI’)

Trends in Harm Perceptions of E-Cigarettes vs Cigarettes Among Adults Who Smoke in England, 2014-2023

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